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Aim:It was aimed to evaluate necessity of performing chest X-ray (CXR) in patients with multiple traumas and injury severity score (ISS) >15 in this study.Materials and Methods:In this cross-sectional study conducted on trauma patients, the clinical and radiographic findings of all the patients were collected and the relationships between these variables were analyzed based on advanced trauma life support guidelines.Results:A total of 170 patients was included in the study. Of them, 114 (67.1%) were male. The mean age of males was 33.86±17.36 years and it was 37.75±18.33 years in females (p=0.181). Twenty six patients had symptoms; seven patients had dyspnea and 19 had chest pain. Clinical examination was abnormal in 28 patients. Emphysema was detected in one patient, ecchymosis in one patient and local tenderness in 26 patients. CXR was performed in all patients and it was normal in 161 patients (94.7%). It detected rib fracture in six patients (3.5%), pulmonary contusion in two patients (1.2%) and hemothorax in one patient (0.6%).Conclusion:Investigation of the necessity of emergency CXR in patients with multiple trauma with ISS >15 showed that there was no need to perform CXR in stable patients lacking signs and symptoms and instead we suggest physical exam to detect any problem.

Objective: Acute mesenteric ischemia (IMA) is a vascular emergency with broad variability of clinical presentations and non-specific laboratory findings. Therefore, there is a significant need for reliable serological markers of ischemia. Various laboratory studies may be performed for suspected AMI, but in general, such studies will not establish the diagnosis. Methods: In a prospective, non-interventional study, from October 2012 to October 2013, we investigated 70 patients with probable diagnosis of AMI. Blood samples were taken from patients and analyzed for complete blood count (CBC), prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), urea, creatinine (Cr), sodium (Na), potassium (K), D-dimer, lactate, amylase, PH, partial pressure of carbon dioxide (PCO2 ), and bicarbonate (HCO3 ). Finally the results were compared with AMI diagnosis confirmed by computed tomography (CT) angiography. Results: Seventy patients with acute severe abdominal pain were studied. Thirty-nine patients (55.7%) were male and 31 patients (44.3%) were female. The average age was 68.01±14.67 (±SD). Based on CT-angiography results, 27 (38.6%) patients had AMI and 43 (61.4%) patients did not have AMI. Chi-squire test showed P values of 0.606 and 0.986 for relations between sex and risk factors with AMI correspondingly. One-sample Kolmogorov-Smirnov revealed white blood cell (WBC), hemoglobin (Hb), platelets (Plt), urea, Cr, Na, K, PCO2 and HCO3 as normally distributed parameters (P>0.05). Moreover PT, PTT, INR, D-dimer, lactate, amylase, and PH were non-normally distributed (P

ABSTRACT: Objective: To differentiate familial hypocalciuric hypercalcemia (FHH), a rare condition, from primary hyperparathyroidism (PHPT), one of the most common causes of hypercalcemia, leading to avoidance of unnecessary surgical treatment; and also to review FHH.Methods: We present the history, physical, laboratory investigations, and clinical course of a 42-year-old woman who presented to our endocrinology office with hypercalcemia. An updated review on FHH is also provided.Results: FHH is a rare genetic disorder resulting from an inactivating mutation in the calcium-sensing receptor (CASR) gene. Inactivation of CASR causes increased parathyroid hormone (PTH) release with mild hypercalcemia. This condition should be differentiated from the other causes of hypercalcemia such as PHPT and malignancy. FHH does not usually have any signs, symptoms, or complications of hypercalcemia. Our patient presented with hypercalcemia with decreased urinary calcium excretion and was positive for a CASR mutation confirming FHH. This patient was able to avoid unnecessary parathyroid surgery based on these findings.Conclusion: FHH is diagnosed by mild hypercalcemia, normal or high PTH, and low urine calcium, and it is differentiated from primary PHPT by measuring the calcium/creatinine clearance ratio and finally genetic testing. FHH is a lifelong benign condition that does not require any treatment or surgery.Abbreviations: Ca calcium; CaSR calcium-sensing receptor; CASR calcium-sensing receptor gene; Cr creatinine; FHH familial hypocalciuric hypercalcemia; PTH parathyroid hormone; PHPT primary hyperparathyroidism